Contributor: Gordon K. Klintworth
Keratoconjunctivitis sicca (dry eye syndrome, keratitis sicca) is an extremely common disorder arising from decreased lacrimal fluid secretion or increased tear film evaporation. This type of  keratitis is predominantly a disorder of women. The incidence of dry eyes is much lower in males. The causes include Sjögren syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis, avitaminosis A, trachoma, chemical burns and irradiation of the eyelids. Symptoms of the syndrome, which include photophobia and a dry or foreign body sensation, are worse on arising and are accentuated by smoke exposure. Affected individuals may become more symptomatic and even worse with unnecessary antibiotic treatment. Individuals with certain types of keratitis, such as staphylococcal keratitis [keratitis - staphylococcal] do not significantly benefit from treatment with artificial tears; therefore, it is important to differentiate these two entities that may have similar symptoms. With aging the incidence of dry eye disease is high in postmenopausal women. A decrease in the circulating levels of androgens may be important in the production of the dry eye.  The risk of severe dry eye is increased in postmenapausal women who take estrogen and progesterone/prostestin replacement therapy.